Transplantation proceedings
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The clinical significance of pretransplant donor-specific antibodies (pre-Tx DSAs) detected by single antigen bead flow cytometry (SAB-FC) remains unclear. Our aim was to investigate the impact that pre-Tx DSAs detected by SAB-FC have on the early and late clinical outcomes. ⋯ Pre-Tx DSAs detected by SAB-FC were more frequent in female recipients, and they were associated with acute vascular and chronic rejection and a poorer graft outcome.
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The aim of this study was to evaluate infection complications as the reason for intensive care unit (ICU) admission among transplant recipients. ⋯ The mortality rate of renal transplant recipients admitted to ICU owing infection complications was higher than that of noninfected renal transplant patients. These data suggest that infections and septic shock in renal transplant recipients requiring ICU admission worsen their outcome significantly.
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During the two last decades remarkable progress has been made among transplantations in Greece. However, organ donation remains a controversial issue. ⋯ Despite knowledge and willingness regarding organ donation, only a small percentage of Greeks are actually registered to be donors.
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Brain death (BD) is defined as the total irreversible loss of brain stem function. According to the Greek legislation, BD diagnosis is based on clinical criteria that test brain stem function. Bispectral Index Scale (BIS), a parameter derived from a mathematical analysis of the electroengephalogram depicts brain activity. The aim of our study was to record BIS alterations in brain-dead patients. ⋯ BIS is a noninvasive, easily interpreted method to monitor cerebral activity. According to our results, BIS could be helpful in BD confirmation but cannot replace the valid clinical tests, which are consistent with Greek legislation for this diagnosis.
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Comparative Study
Long-term outcome of high-urgency heart transplant patients with and without temporary ventricular assist device support.
The use of short-term ventricular assist devices (VAD) in patients awaiting high-urgency (HU) heart transplantation (HTx) in Spain has steadily increased due to longer waiting times and the new heart allocation system. It is unknown whether the use of short-term VAD support in patients with cardiogenic shock affects HTx outcome. We sought to investigate long-term outcomes of HU transplanted patients with VAD compared with HU transplanted patients without device support. ⋯ In our experience, the long-term outcome of patients receiving HU-HTx under short-term VAD support is comparable to that of patients undergoing HU-HTx without VAD support. Patients with renal failure had an increased risk for overall mortality in this set of patients.